Problem         Each unit uses different Clinical 
                    Information Systems (CIS) for important 
                    reasons. 
                    1. ER CIS is compatible with Ambulance 
                     and Paramedic system (e- 
                     Critical/Clinibase)
                    2. Trauma Unit is specific for long term 
                     stay and used throughout the hospital 
                     (Sunrise Clinical Manager (SCM)).    
                    Operational consequences: 
                    • duplication of tasks 
                    • increased potential for errors 
                    • increased workload for nursing 
                     staff
                    • decreased overall system efficiency
                    • Potential for errors, missed 
                     information and poor patient care 
                   Solution 
          • Consult the staff
          • Test a new CIS and gain staff 
            input 
          • Make a plan
                                               dbMotion:
          • Develop a team                     A Health Information 
          • Integrate the platform for         Exchange (HIE)
            interoperability of hospital 
            clinical information systems 
            and cloud based storage and 
            transfer of information.
     Health Information Exchange 
   Cloud-based hospital   (HIE)
   information systems 
   are becoming more 
   widespread and are 
   an effective            HIE  is  a  common  theme  in 
   mechanism to            developing  frameworks  for 
   facilitate HIE and      sharing    and     exchanging 
   provide better          health information across the 
   healthcare services to  many  healthcare  providers 
   patients (Reddy &       involved  in  a  patient’s  care, 
   Reddy, 2014).           and    to    ensure    smooth 
                           transitions  from  one  setting 
                           to the next (British Columbia 
                           Ministry  of  Health,  2015; 
                           Frisse  et  al.,  2011;  Health 
                           Quality Ontario, 2013). 
  Team
       Manageme
       Manageme
       nt Team/IT 
       nt Team/IT 
          Team
          Team             Leader 
                           Leader 
                          (Experienced ER 
                          (Experienced ER 
                            Nurse) / 
                            Nurse) / 
                         Informatics 
                         Informatics 
                         Consultant 
                         Consultant 
            5 –phases with ‘10 Considerations’ 
                           Integrated
                                 1) Discussion Phase: 
                       Clarify problem(s) that the technology is meant to 
   Create a plan and                   help tackle
                                     Build consensus
       a realistic                          
       timeline                    2) Testing Phase:
                                    Consider Options
                       Choose systems that meet the clinical needs and 
                                      is affordable
                                            
                                  3) Change Phase:
                                    Plan appropriately
                                            
                              4) Implementation/Rollout:
                               Don’t forget the infrastructure
                                       Train Staff
                                            
                                 5) Evaluation Phase:
                             Continuously evaluate the process
                                   Maintain the system
                                     Stay the course
                                    (Cresswell et al., 2013)